Ideal

Posterior View

• Medial borders are same distance from spine (5 cm Kendall)
• Medial borders are parallel to spine
• Scapula is held firmly to the rib cage
• Scapula is rotated 30° anteriorly to the frontal plane

Lateral View

• Middle of the acromion process is on the plumb line
• Scapula is held firmly to the rib cage

You See

• Medial border is further away from mid line (if medial border is not parallel to spine, scapula might also be in upward or downward rotation)
• Rounded Shoulders
• Arms are medially rotated
• Scapula is depressed
• More of back of hands visible in anterior view

Likely Cause

• Short scapular protractors, especially pectoralis minor and pectoralis major (indirectly on humerus)
• Short subscapularis (with medial rotation of the arm)
• Long scapular retractors (look for hypertrophy especially in rhomboids and mid trapezius)
• Rounded shoulders
• Long (thoracic) spine extensors
• Kyphosis